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Karma 8020 Wheelchair - 0 views

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    Heavy duty wheelchair can either be manually-operated or motorized, each with its own pros and cons. A manual heavy-duty wheelchair gives full control of motion to the user, but the added weight from the reinforcements makes pushing or propelling the wheelchair much harder than normal. A motorized heavy duty wheelchair offers a solution to this dilemma, but is often more expensive and harder to maintain than a manual wheelchair. Some designs offer a combination of both, with a small motor assisting those pushing the wheelchair. The proper choice between types of Heavy Duty wheelchair depends largely on the user's expected level of activity. Heavy duty wheelchairs typically have larger seats than conventional wheelchairs. The frames of these wheelchairs can be made from several different reinforced metals, although a titanium wheelchair is often the most popular choice. The wheels themselves are made of thicker rubber than normal, preventing any possible failure due to the greater amount of weight supported. Most makes of heavy duty wheelchairs fold like regular wheelchairs, making storage relatively easy despite the wheelchair increased size. Heavy Duty Wheelchair specialy design for disabled and handicapped persons. They are two types of Heavy Duty Wheelchair for handicapped and disability product like- karma 8020 X Heavy Duty Wheelchair karma 8520 Heavy Duty Wheelchair karma 8020 X Heavy Duty Wheelchair: It comes with detachable swing away footrests. The wheel chair has flip-back armrests. It comes with centre of gravity adjustment. The wheel chair has wide profile casters. Seat Size 20'' inch & 22'' inch Total Weight 17 k.G. Designed for maximum strength & weight capacity for people over 250 lbs. These end to be heavier and wider. This heavy duty bariatric wheelchair has seat dimensions of 24 inches wide by 18 inches deep to accommodate a weight capacity of up to 400 lbs. This wheelchair is dual axle, which means that the floor to seat heigh
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Transport Chairs - 0 views

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    Lightweight wheelchairs provide convenience and comfort to the user and caregiver alike and are often built using materials like aluminum and titanium alloy, while foldable wheelchairs allow for easy storage and transport. Merge the two styles, and got a great mobility aid that isn't a pain to lug around. Utilizing small wheels and lighter materials, transport wheelchairs can tip the scale at as little as 19 lbs, ideal for those looking for a highly portable option. Transport chairs also tend to be more affordable and offer the benefit of increased mobility without breaking the bank. This type of lightweight wheelchair is often referred to as a "transfer chair" and is typically used for shorter trips. Since it's geared towards storability and portability, it features four smaller wheels and dispenses with the larger, rear-mounted wheels that characterize standard wheelchairs. Its construction ensures that it's always foldable and portable, but does so at the expense of self-propulsion. Instead, a transport chair is built so that a caregiver can easily push the user. Transport wheelchairs or companion chairs are companion wheelchairs where the purpose is for a companion to push the user. Most transporters have swing-away leg rests, fixed armrests, and side panels. Instead of the usual 'large back - small front' wheels typical of most wheelchairs, light travel chairs have four small wheels providing much easier maneuverability of the chair. karma Travel Wheelchair kM TV 20.2: karma Travel Wheelchair kM TV 20.2 - 606 T-6 aircraft-grade aluminum-alloy frame provides incredible strength. Easy-to-fold in three seconds. karma Travel Wheelchair kM TV 20.2 Features: Type: Travel Wheelchair. T-6 aircraft-grade aluminum. Secure brake improve safety. Padded flip back armrest. PU front caster & rear wheel. karma Travel Wheelchair kM TV 20.2 Measurements: Weight: 8.9kg. Seat width: 39.5cm. Tyre: PU front casters and rear wheels. Capacity: 100
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Original Articles: Comparison of Insulin Action on Glucose versus Potassium Uptake in H... - 0 views

  • When treating hyperkalemia, insulin remains efficacious in diabetics and nondiabetics and one does not need to resort to b-agonists, and diabetics do not require different doses of insulin to shift potassium
  • the commonly encountered “insulin-resistant” patients actually have preserved insulin-induced potassium disposal, one wonders why their high insulin levels are not causing hypokalemia
  • insulin independently regulates glucose and potassium uptake into cells and this independence explains why in noninsulin-dependent diabetic insulin resistance leads to impaired insulin uptake into cells but has no effect on the cell's potassium disposal
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  • insulin suppresses glycogenolysis, gluconeogenesis, lipolysis and fatty acid release, and protein catabolism and is the principal hormone that stimulates glucose uptake into mainly skeletal muscle and to a certain extent adipocytes
  • Plasma [K+] is a major determinant of the resting potential of all cells
  • Hyperkalemia and hypokalemia are silent yet fatal disturbances because of their arrhythmogenic potentials
  • Basal insulin maintains fasting plasma [K+] within the normal range
  • When insulin levels are suppressed, plasma [K+] rises and pronounced hyperKalemia develops after a potassium load
  • Potassium is a well proven insulin secretagogue
  • Insulin is a key defender against exogenous potassium load by using intracellular buffering to minimize hyperkalemia before renal excretion
  • Hyperkalemia is often encountered in patients with diabetes
  • The insulin-deficient state in type 1 diabetes predisposes to hyperkalemia because of an impaired ability of potassium to enter cells. During hyperglycemic hypertonic states in type 1 and type 2 diabetics, potassium is carried out of cells by convective flux as the most abundant intracellular cation
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    good review of the potassium, glucose, insulin relationship mostly in diabetes.  In diabetes, hyperkalemia is present due to the hyperglycemia and the associated exchange.  Inuslin independantly regulates potassium and glucose intake into the cell.  INterestingly, in IR found in diabetes, the hyperkalemia is the norm, which should cause hypokalemia--the authors were perplexed by this finding.
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Testosterone relaxes coronary arteries by opening the large-conductance, calcium-activa... - 0 views

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    The androgens testosterone and DHT elicit vasodilation via calcium and potassium channel activation.  The vasodilatory effect of the androgens is through, in part, due to K activated Ca channels.  Also of note, DHT had the same effect and DHT cannot be aromatized to estrogen.
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Tolerance and safety of vitamin E: a toxicological position report. - PubMed - NCBI - 0 views

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    Only abstract available here.  The quote that "the toxicity of vitamin E is very low" tells the story.  Always have levels evaluated to ensure need.  In this review of human studies, doses up to 3,200 IU daily "led to no consistent adverse effects".  Also consider the effects of vitamin K effects in those on vitamin E therapy.
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Thyroid hormones in fibrocystic breast dise... [Eur J Endocrinol. 1995] - PubMed - NCBI - 0 views

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    free T3 levels found to be higher in breast cyst fluid than in serum. This correlated with elevated K+/Na+ ratio which is associated with malignant transformation.  This elevated free breast cyst fluid correlated with estradiol concentration
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Effects of sodium ascorbate (vitamin ... [Anticancer Res. 1993 Jan-Feb] - PubMed - NCBI - 0 views

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    IV vitamin K3 shown to provide synergy with IV vitamin C in vitro study of cancer cells.
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Cytotoxic Effects of Klebsiella oxytoca Strains Isolated from Patients with Antibiotic-... - 0 views

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    Colitis as a result of K. oxytoca
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Heavy Duty Wheelchair - 0 views

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    Bariatric wheelchairs (often referred to as extra wide wheelchairs or heavy duty wheelchairs) are strong enough to accommodate almost any user. Just like lighter manual chairs, bariatric wheelchairs are all foldable and feature armrests and swing-away footrests - but they differ quite a bit in their construction. While lightweight wheelchairs often employ materials like aluminum or titanium alloy, a bariatric wheelchair is usually fashioned from steel. karma 8020 X Heavy Duty Wheelchair: It comes with detachable swing away footrests. The wheel chair has flip-back armrests. It comes with centre of gravity adjustment. The wheel chair has wide profile casters. Seat Size 20'' inch & 22'' inch Total Weight 17 k.G. Heavy duty wheelchairs (often referred to as extra wide wheelchairs or bariatric wheelchairs) are sturdy enough to accommodate almost any user. Just their lighter cousins, manual chairs, heavy duty models all fold and feature arm rests and swing-away footrests - but they differ quite a bit in their construction. Heavy duty wheelchairs require more strength to push by the caregiver and by the user, if the chair is self-propelled. In some cases, it may be wise for the caregiver to ask for assistance from another person in order to push the wheelchair safely. karma 8520 Heavy Duty Wheelchair: It comes with detachable swing away footrests. The wheel chair has flip-back armrests. It comes with centre of gravity adjustment. The wheel chair has wide profile casters. Seat Size 20'' inch & 22'' inch Total Weight 17 k.G. Features: Dual, reinforced steel cross braces. Supports individuals maximum weight. Reinforced steel frame provides added support. Heavy duty, nylon reinforced upholstery with a back carry pouch. Removable, reversible desk length arms. Adjustable leg support.
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Karma Aurora 4 - 0 views

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    Karma Aurora 4 Reclining Wheelchair Frame Style : Fordable Frame Material : Aluminium (Light weight) Seat Width (inches) : 18" Total width in wheel to wheel : 11" Rear Wheel Size : 24" Front Wheel Size : 7" Seat to floor height (inches) : 20" Seat Depth (inches) : 16" BacK height (inches) : 35" Total height (inches) : 50" Max User Weight Capacity (Kgs) : 120 Frame Net Weight (Kgs) : 13.5 K.g. Upholstery : Cloth water-proof. Armrest : Detachable, for easy transfer to bed. Leg-rest : Detachable, can also be elevated & with calf support for added comfort Wheel Quality : MAG WHEEL Rear Wheel BraKes : Available Hand braKes : Available
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Commode Wheelchair - 0 views

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    This lightweight portable shower chair commode with casters is packed with features to ensure a pleasant and comfortable bathing experience. One of the greatest benefits is the ultra comfort padded seat featuring an open front design making personal hygiene easy and convenient. When the shower chair is not in use the back and 12 qt. commode bucket can be removed without tools making cleaning and storage simple. The frame is manufactured with lightweight rust resistant anodized aluminum able to withstand a 300 lb. weight capacity. Easy to operate, shower chair. Commode comes equipped with 3" non-skid casters, making transfer to and from any bathroom safe and secure. Commode/shower chair soft seat features strong and practical armrests designed to withstand a lot of load, including the sideways forces that are exerted during sideways transfers.The armrests offer comfortable support for the forearms while sitting and they are long enough to provide sustained support when standing up and sitting down. The armrests can be folded up individually, e.g. to facilitate a sideways transfers. When folded down, the armrest rests behind the backrest thereby preventing fingers, skin or hair from getting caught. Commode Wheelchair Rainbow 6: karma commode wheelchair rainbow 6 comes with lot of exiting features for elderly or physically challenged person who want commode in wheelchair. karma Rainbow 6 has single seat with center cut commode having cushion cover on top and removable pan or plastic commode seat with pot. Commode Wheelchair Rainbow 6 Features: Frame Material : M.S.Chrome Plated Single Seat with center cut commode Both Option Available In Single Seat Plastic Commode Seat With Pot. Cushioned Top Cover Square Pan Commode Pan Removable Pan Commode Wheelchair Rainbow 6 Measurements: Frame Style : Foldable Open Position Wheel To Wheel Width In : 26" (Inches) Seat Width : 18" (Inches) Total Width in Closing Position : 11" (Inches) Rear Whe
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Karma KM-8520 - 0 views

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    Karma 8520 or Karma KM-8520 Heavy Duty Wheelchair specialy design for disabled and handicapped persons. Some features are mentioned below- Features- It comes with detachable swing away footrests. The wheel chair has flip-bacK armrests. It comes with centre of gravity adjustment. The wheel chair has wide profile casters. Seat Size 20'' inch & 22'' inch Total Weight 17 K.G. Karma 8520 Heavy Duty Wheelchair Item Code and Price Item Code: WCI-29 MRP: Rs 32085 Our Price: Rs 24063 Net Price:Rs23582( Apply Coupon Code 'MSW2365' Get 2% Discount ) Heavy Duty Wheelchair for handicapped and disabled at lowest and cheap cost price in india, Bariatric Wheelchair online shopping store of Heavy Duty Wheelchairs distributor, dealer and supplier. Variety of Heavy Duty Wheelchair, Karma Heavy Duty Wheelchair, Wheelchair Bariatric, Wheelchair Heavy Duty, Buy Heavy Duty Wheelchair, Bariatric Wheelchair online shopping at low price in india Along with that we offer huge discount and promo code when you purchase HEAVY DUTY WHEELCHAIR from our online shopping store of Heavy Duty Wheelchair, Heavy Duty Wheelchairs, Bariatric Wheelchair, Wheelchair Bariatric, Best Wheelchair for Heavy Person, Wheelchair Heavy Duty, Buy Heavy Duty Wheelchair, Wheelchair Bariatric India, Heavy Duty Wheelchairs price, Bariatric Wheelchair online shopping, Wheelchair Heavy Duty for sale.
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Soma SM 100.3 - 0 views

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    Soma SM 100.3 The SM-100.3 is an aluminum alloy standard wheelchair that is economic, solid, and durable. Soma SM 100.3 Wheelchair Features: Elliptical frame The unique and stylish elliptical frame ensures that the chair is both rigid and robust. Integrated seating system For intensive wheelchair users, we provide seating system that can be free from hammock effect. The innovative and durable seating system makes it easy for you to detach seat upholstery for cleaning purpose. Secure non-slip footplate A non-slip and ergonomic footplate provides you with a stable and comfortable base for placing feet. Energy-saving tipping lever The ergonomic design allows caregivers to operate the lever without much effort so the casters can overcome obstacles such as thresholds and curbs. Soma SM 100.3 Wheelchair Measurements: Seat Width(cm):43 Seat Depth(cm):42 Caster Size(inch):7 Rear Wheel Size(Inch/QR) 16F/22F
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The Pharmacokinetics and Interactions of Ivermectin in Humans-A Mini-review - 0 views

  • This drug is extensively metabolized by human liver microsomes by cytochrome P450
  • cytochrome P-4503A4, converting the drug to at least 10 metabolites
  • its elimination half-life is around a day
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  • second rise in plasma levels (mostly occurring between 6 and 12 h after the dose) suggesting an enterohepatic recycling of the drug
  • Ivermectin is exceptionally potent, with effective dosages levels that are unusually low.
  • the optimal dose of ivermectin is 150 μg/kg, but the frequency of administration is still controversial, ranging from 150 μg/kg once to three times yearly.
  • high lipid solubility of ivermectin, this compound is widely distributed within the body.
  • To interrupt the transmission of onchocerciasis in humans, the combination of ivermectin and doxycycline is highly effective as, in infested patients, the ingestion of the anthelmintic (200 μg/kg, single dose) and the antibacterial (100 mg/kg, daily for 6 weeks)
  • ivermectin interactions with another concurrently administered drugs can occur.
  • This issue becames important, as combination chemotherapy is being used with increasing frequency as resistance to antiparasitic agents is becoming more widespread.
  • haematomatous swellings
  • prothrombin times were significantly above baseline by one week to one month after drug ingestion, suggesting an antagonist effect against vitamin k
  • bleeding disorders were not found in 15,000 patients treated with ivermectin (150 μg/kg)
  • prolonged prothrombin ratios were observed in 148 subjects given ivermectin orally. Although no patients suffered bleeding complications, factor II and VII levels were reduced in most of them, suggesting interference with vitamin K metabolism
  • Ivermectin has a minimal effect on coagulation and concern about mass treatment for this reason appears to be unjustified
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    Review of Ivermectin as an anti-parasitic.
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Demystified . . . Human endogenous retroviruses - 0 views

  • HERVs have been inherited by successive generations and it is possible that some have conferred biological benefits
  • However, several HERVs have been implicated in certain cancers and autoimmune diseases
  • HERVs constitute about 1% of the human genome
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  • Human endogenous retroviruses (HERVs) represent footprints of previous retroviral infection and have been termed “fossil viruses”
  • HERVs possess a similar genomic organisation to present day exogenous retroviruses such as human immunodeficiency virus (HIV) and human T cell leukaemia virus (HTLV)
  • Retroviruses in effect are retrograde, because the flow of genetic information is reversed compared with the normal pathway of molecular biosynthesis—DNA → RNA → protein. Indeed, all retroviruses necessitate the conversion of viral RNA into a cDNA intermediary, which is catalysed by the enzyme reverse transcriptase
  • Overall, human endogenous retroviruses constitute about 1% of the human genome”
  • some HERVs have been implicated in certain autoimmune diseases and cancers
  • A unit of sugar, phosphate, and base is strictly termed a nucleotide
  • human genes are composed of exons, which are transcribed and translated into amino acids
  • introns, which are interspersed between exons and represent non-translated regions that contribute to the large size of some genes
  • convincing argument for the possible involvement of HERVs in malignancy
  • HERVs may be involved in carcinogenesis by virtue of the expression of HERV mRNA,26 functional proteins,27 or retroviral-like particles
  • They may also be associated with the generation of new promoters29 or the activation of proto-oncogenes
  • inhibition of an effective immune response,
  • encode immunosuppressive proteins
  • “It has been suggested that HERV-K may be important in the progression of testicular germ cell tumours through inhibition of an effective immune response”
  • HERV-K might be important in the pathogenesis of human breast cancer
  • activation of proto-oncogenes of the ras family is common in many tumour types, and some studies have suggested a potential role for HERVs in ras activation
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    good review of HERVs.
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Diabetes Care - 0 views

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    supplementation of Vitamin K2 in healthy men improved insulin sensitivity.  The question of whether it improves insulin sensitivity in unhealthy men and/or diabetes is not confirmed here.
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Testosterone: a vascular hormone in health and disease - 0 views

  • Testosterone has beneficial effects on several cardiovascular risk factors, which include cholesterol, endothelial dysfunction and inflammation
  • In clinical studies, acute and chronic testosterone administration increases coronary artery diameter and flow, improves cardiac ischaemia and symptoms in men with chronic stable angina and reduces peripheral vascular resistance in chronic heart failure.
  • testosterone is an L-calcium channel blocker and induces potassium channel activation in vascular smooth muscle cells
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  • Animal studies have consistently demonstrated that testosterone is atheroprotective, whereas testosterone deficiency promotes the early stages of atherogenesis
  • there is no compelling evidence that testosterone replacement to levels within the normal healthy range contributes adversely to the pathogenesis of CVD (Carson & Rosano 2011) or prostate cancer (Morgentaler & Schulman 2009)
  • bidirectional effect between decreased testosterone concentrations and disease pathology exists as concomitant cardiovascular risk factors (including inflammation, obesity and insulin resistance) are known to reduce testosterone levels and that testosterone confers beneficial effects on these cardiovascular risk factors
  • Achieving a normal physiological testosterone concentration through the administration of testosterone replacement therapy (TRT) has been shown to improve risk factors for atherosclerosis including reducing central adiposity and insulin resistance and improving lipid profiles (in particular, lowering cholesterol), clotting and inflammatory profiles and vascular function
  • It is well known that impaired erectile function and CVD are closely related in that ED can be the first clinical manifestation of atherosclerosis often preceding a cardiovascular event by 3–5 years
  • no decrease in the response (i.e. no tachyphylaxis) of testosterone and that patient benefit persists in the long term.
  • free testosterone levels within the physiological range, has been shown to result in a marked increase in both flow- and nitroglycerin-mediated brachial artery vasodilation in men with CAD
  • Clinical studies, however, have revealed either small reductions of 2–3 mm in diastolic pressure or no significant effects when testosterone is replaced within normal physiological limits in humans
  • Endothelium-independent mechanisms of testosterone are considered to occur primarily via the inhibition of voltage-operated Ca2+ channels (VOCCs) and/or activation of K+ channels (KCs) on smooth muscle cells (SMCs)
  • Testosterone shares the same molecular binding site as nifedipine
  • Testosterone increases the expression of endothelial nitric oxide synthase (eNOS) and enhances nitric oxide (NO) production
  • Testosterone also inhibited the Ca2+ influx response to PGF2α
  • one of the major actions of testosterone is on NO and its signalling pathways
  • In addition to direct effects on NOS expression, testosterone may also affect phosphodiesterase type 5 (PDE5 (PDE5A)) gene expression, an enzyme controlling the degradation of cGMP, which acts as a vasodilatory second messenger
  • the significance of the action of testosterone on VSMC apoptosis and proliferation in atherosclerosis is difficult to delineate and may be dependent upon the stage of plaque development
  • Several human studies have shown that carotid IMT (CIMT) and aortic calcification negatively correlate with serum testosterone
  • t long-term testosterone treatment reduced CIMT in men with low testosterone levels and angina
  • neither intracellular nor membrane-associated ARs are required for the rapid vasodilator effect
  • acute responses appear to be AR independent, long-term AR-mediated effects on the vasculature have also been described, primarily in the context of vascular tone regulation via the modulation of gene transcription
  • Testosterone and DHT increased the expression of eNOS in HUVECs
  • oestrogens have been shown to activate eNOS and stimulate NO production in an ERα-dependent manner
  • Several studies, however, have demonstrated that the vasodilatory actions of testosterone are not reduced by aromatase inhibition
  • non-aromatisable DHT elicited similar vasodilation to testosterone treatment in arterial smooth muscle
  • increased endothelial NOS (eNOS) expression and phosphorylation were observed in testosterone- and DHT-treated human umbilical vein endothelial cells
  • Androgen deprivation leads to a reduction in neuronal NOS expression associated with a decrease of intracavernosal pressure in penile arteries during erection, an effect that is promptly reversed by androgen replacement therapy
  • Observational evidence suggests that several pro-inflammatory cytokines (including interleukin 1β (IL1β), IL6, tumour necrosis factor α (TNFα), and highly sensitive CRP) and serum testosterone levels are inversely associated in patients with CAD, T2DM and/or hypogonadism
  • patients with the highest IL1β concentrations had lower endogenous testosterone levels
  • TRT has been reported to significantly reduce TNFα and elevate the circulating anti-inflammatory IL10 in hypogonadal men with CVD
  • testosterone treatment to normalise levels in hypogonadal men with the MetS resulted in a significant reduction in the circulating CRP, IL1β and TNFα, with a trend towards lower IL6 compared with placebo
  • parenteral testosterone undecanoate, CRP decreased significantly in hypogonadal elderly men
  • Higher levels of serum adiponectin have been shown to lower cardiovascular risk
  • Research suggests that the expression of VCAM-1, as induced by pro-inflammatory cytokines such as TNFα or interferon γ (IFNγ (IFNG)) in endothelial cells, can be attenuated by treatment with testosterone
  • Testosterone also inhibits the production of pro-inflammatory cytokines such as IL6, IL1β and TNFα in a range of cell types including human endothelial cells
  • decreased inflammatory response to TNFα and lipopolysaccharide (LPS) in human endothelial cells when treated with DHT
  • The key to unravelling the link between testosterone and its role in atherosclerosis may lay in the understanding of testosterone signalling and the cross-talk between receptors and intracellular events that result in pro- and/or anti-inflammatory actions in athero-sensitive cells.
  • testosterone functions through the AR to modulate adhesion molecule expression
  • pre-treatment with DHT reduced the cytokine-stimulated inflammatory response
  • DHT inhibited NFκB activation
  • DHT could inhibit an LPS-induced upregulation of MCP1
  • Both NFκB and AR act at the transcriptional level and have been experimentally found to be antagonistic to each other
  • As the AR and NFκB are mutual antagonists, their interaction and influence on functions can be bidirectional, with inflammatory agents that activate NFκB interfering with normal androgen signalling as well as the AR interrupting NFκB inflammatory transcription
  • prolonged exposure of vascular cells to the inflammatory activation of NFκB associated with atherosclerosis may reduce or alter any potentially protective effects of testosterone
  • DHT and IFNγ also modulate each other's signalling through interaction at the transcriptional level, suggesting that androgens down-regulate IFN-induced genes
  • (Simoncini et al. 2000a,b). Norata et al. (2010) suggest that part of the testosterone-mediated atheroprotective effects could depend on ER activation mediated by the testosterone/DHT 3β-derivative, 3β-Adiol
  • TNFα-induced induction of ICAM-1, VCAM-1 and E-selectin as well as MCP1 and IL6 was significantly reduced by a pre-incubation with 3β-Adiol in HUVECs
  • 3β-Adiol also reduced LPS-induced gene expression of IL6, TNFα, cyclooxygenase 2 (COX2 (PTGS2)), CD40, CX3CR1, plasminogen activator inhibitor-1, MMP9, resistin, pentraxin-3 and MCP1 in the monocytic cell line U937 (Norata et al. 2010)
  • This study suggests that testosterone metabolites, other than those generated through aromatisation, could exert anti-inflammatory effects that are mediated by ER activation.
  • The authors suggest that DHT differentially effects COX2 levels under physiological and pathophysiological conditions in human coronary artery smooth muscle cells and via AR-dependent and -independent mechanisms influenced by the physiological state of the cell
  • There are, however, a number of systematic meta-analyses of clinical trials of TRT that have not demonstrated an increased risk of adverse cardiovascular events or mortality
  • The TOM trial, which was designed to investigate the effect of TRT on frailty in elderly men, was terminated prematurely as a result of an increased incidence of cardiovascular-related events after 6 months in the treatment arm
  • trials of TRT in men with either chronic stable angina or chronic cardiac failure have also found no increase in either cardiovascular events or mortality in studies up to 12 months
  • Evidence may therefore suggest that low testosterone levels and testosterone levels above the normal range have an adverse effect on CVD, whereas testosterone levels titrated to within the mid- to upper-normal range have at least a neutral effect or, taking into account the knowledge of the beneficial effects of testosterone on a series of cardiovascular risk factors, there may possibly be a cardioprotective action
  • The effect of testosterone on human vascular function is a complex issue and may be dependent upon the underlying androgen and/or disease status.
  • the majority of studies suggest that testosterone may display both acute and chronic vasodilatory effects upon various vascular beds at both physiological and supraphysiological concentrations and via endothelium-dependent and -independent mechanisms
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    Good deep look into the testosterone and CVD link.
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Beyond the male sex hormone: deciphering the metabolic and vascular actions of testoste... - 0 views

  • androgen deprivation therapy results in unfavorable changes in body composition, insulin resistance, and dyslipidemia and predisposes men to develop atherosclerosis and an increased risk of cardiovascular mortality
  • The hypogonadal–obesity cycle hypothesis was originally proposed by Cohen in 1999 to explain the relationship between low testosterone levels and metabolic disease. It was based on the finding that obesity impairs testosterone levels by increasing the aromatization of testosterone to estradiol, while low testosterone levels promote increased fat deposition
  • adipocytokines contribute to low testosterone levels as well as to the processes underlying metabolic syndromes and type 2 diabetes
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  • hypogonadal–obesity–adipocytokine hypothesis
  • The presence of estradiol and the adipocytokines TNF-α, IL6, and leptin (as a result of leptin resistance in obesity) inhibits the hypothalamic–pituitary–testicular axis response to decreasing androgen levels
  • An increasing number of studies have illustrated the potential for applying metabolomics to the field of androgen research
  • As early as the 1940s, the therapeutic use of testosterone was reported to improve angina pectoris in men with coronary artery disease
  • most of the epidemiological studies reported increased cardiovascular risk and mortality in men with low testosterone levels
  • long-term testosterone replacement appears to be a safe and effective means of treating hypogonadal elderly men
  • a recent interventional trial showed that testosterone treatment was associated with decreased mortality when compared with no testosterone treatment in an observational cohort of men with low testosterone levels
  • a number of short-term studies conducted support the notion that testosterone therapy reduces the cardiovascular risk
  • The majority of animal studies support the hypothesis that the actions of testosterone on vascular relaxation are both endothelium-dependent and -independent vasodilatory effects
  • Endothelial-dependent actions of testosterone increase the expression or activity of endothelial nitric oxide synthase and enhance nitric oxide production, which in turn activates cyclic guanosine monophosphate to induce vasorelaxation in smooth muscle cells
  • Endothelial-independent mechanisms of testosterone are believed to occur primarily via inhibition of voltage-operated Ca2+ channels and/or activation of K+ channels in smooth muscle cells
  • Testosterone may also inhibit intracellular Ca2+ influx via store-operated Ca2+ channels by blocking the response to prostaglandin F2α
  • testosterone has demonstrated anti-inflammatory effects to protect against atherogenesis in animal studies
  • both genomic AR activation to modulate gene transcription and non-genomic activation to modulate the rapid intracellular signaling pathways of ion channels may mediate testosterone effects on vascular function and inflammation.
  • Butenandt & Ruzicka first showed how testosterone is synthesized and responsible for masculine characteristics in the early 1930s
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    Awesome review on the current understanding of Testosterone and Diabetes, metabolic syndrome, and CVD.  This article even goes into the literature on androgen receptors.
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The Journal of Bone & Joint Surgery | Article - 0 views

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    It is no surprise that hyperglycemia is associated with increased hospital stay and post operative infection.  I have seen this in my former population.  Especially in prolapse and incontinence surgeries (which I no longer perform).  However, what is interesting is that 1/3 of the non-diabetics are hyperglycemic.  The preparation of the individual has just as much to do with the successful outcome of the surgery as does the surgery itself.
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